Irritable Bowel Syndrome: Care Instructions

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Irritable bowel syndrome, or IBS, is a problem with the intestines that causes belly pain, bloating, gas, constipation, and diarrhea. The cause of IBS is not well known. IBS can last for many years, but it does not get worse over time or lead to serious disease.

Most people can control their symptoms by changing their diet and avoiding things that make their symptoms worse.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Keep track of foods and symptoms.
    • Keep a food diary to track what you eat. Also record when you have symptoms and what they are. There are phone apps that can help, or you can just write it down.
    • A food diary can help you figure out if certain foods trigger symptoms and if cutting out certain foods helps.
    • When you make changes to your diet, plan on it taking about 6 weeks to know if the changes help.
  • To reduce pain, gas, and bloating:
    • Try adding soluble fiber every day. This is the kind that dissolves in water. Some foods with soluble fiber are oats and fruit without skin. Some supplements you can try are Citrucel and Benefiber.
    • Try a low-FODMAP diet. FODMAPs are types of carbohydrates that can make IBS symptoms worse. Your doctor or a registered dietitian can help you with this diet.
  • To reduce constipation:
    • Talk to your doctor or a dietitian about whether you should increase how much fiber you eat. If they suggest more fiber:
      • Try soluble fiber first.
      • If they recommend more insoluble fiber, go slow. Add a little bit at a time. Insoluble fiber is in fruits and vegetables with skin, most whole grains, and beans.
    • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
    • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
  • To reduce diarrhea, limit or avoid:
    • Alcohol.
    • Caffeine, which is found in coffee, tea, cola drinks, energy drinks, and chocolate.
    • Nicotine from smoking or chewing tobacco.
    • Gas-producing foods, such as beans, broccoli, cabbage, or apples.
    • Dairy products that contain lactose (milk sugar), such as ice cream or milk.
    • Foods and drinks high in sugar, especially fruit juice, soda, candy, and other packaged sweets (such as cookies).
    • Foods high in fat, including bacon, sausage, butter, oils, and anything deep-fried.
    • Sugar alcohols like sorbitol, xylitol, mannitol, and isomalt. These are artificial sweeteners found in some sugarless candies and chewing gum.
  • Take medicines exactly as directed.
  • If you are in counseling to help with pain, follow your treatment plan carefully.
  • If you are getting physical therapy to help with your bowel movements, make sure you do your home exercises.
  • If stress makes your symptoms worse, look for ways to reduce stress.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • Your pain is different than usual or occurs with fever.
  • You lose weight without trying, or you lose your appetite and you do not know why.
  • Your symptoms often wake you from sleep.
  • Your stools are black and tarlike or have streaks of blood.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your IBS symptoms get worse or begin to disrupt your day-to-day life.
  • You become more tired than usual.
  • Your home treatment stops working.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.